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Women of Distinction Nomination Form
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Women of Distinction Nomination Form
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Women of Distinction Nomination Form
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Women of Distinction Nomination Form
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*
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NOMINEE CONTACT INFORMATION
Name
*
First
Last
Mailing Address
*
Street Address
City
State / Province / Region
ZIP / Postal Code
Employer
*
Title
*
Phone (W)
Phone (C)
Email
*
Nominee Demographics
*
In keeping with the YWCA mission to eliminate racism and empower women, the YWCA ensures that the Woman of Distinction award recipients reflect the rich diversity of the community. Please help us to achieve this goal by indicating the group with which the nominee identifies. (Mark all that apply)
American Indian or Alaska Native
Asian
Black or African American
Latina or Hispanic
Native Hawaiian or Asian Pacific Islander
White
Other
Age Range
*
Under 30
30-45
46-64
65+
Is the nominee aware of her nomination?
*
Yes
No
Describe your relationship to/with the nominee:
*
Summarize your nominee's accomplishments/awards:
*
How has this person served as a role model for others in her community or her profession?
*
How has the nominee demonstrated sustained excellence, accomplishment, and creativity in her profession?
*
How has the nominee shown that she actively supports the YWCA mission of eliminating racism and empowering women?
*
How has the nominee given back to the community through her time, talent and/or resources? How has the nominee shown initiative or taken on a leadership role as a volunteer?
*
State any other reasons why this nominee should be recognized as a Woman of Distinction
NOMINATOR INFORMATION
Name
*
First
Last
Address
*
Street Address
City
State / Province / Region
ZIP / Postal Code
Phone (W)
*
Phone (C)
Email
*
SUBMISSION INFORMATION
All nominations must be submitted online. It is important to note that work cannot be saved in the online form. It is recommended that you complete your work in a word possessing program, such as Microsoft Word, and then copy and paste it into the digital form when you are ready to submit form.
